title: Less-established risk factors are common in Asian Americans with hepatitis C virus: a case-controlled study.
abstract: OBJECTIVE
  The Centers for Disease Control and Prevention recommend screening for hepatitis C virus (HCV) in patients with injection drug use, blood transfusion before 1992, stigmata of liver disease, or born between 1945 and 1965. The purpose of this study was to examine risk factors for HCV acquisition in Asian Americans.
  
  
  METHODS
  This was a case-controlled study, with 471 consecutive patients testing positive for anti-HCV between January 2001 and December 2008. Controls included 471 patients with negative HCV matched at a one-to-one ratio for sex, age (±5 years), and ethnicity.
  
  
  RESULTS
  For Asian patients, the most common risk factors were blood transfusion and acupuncture or exposure to dirty needles (27 and 20 %, respectively). On multiple logistic regression, potential predictors for a positive anti-HCV test in Asians were acupuncture or exposure to dirty needles (OR = 12.9, P < 0.0001), body tattoo (OR = 12.0, P = 0.001), and history of blood transfusion (OR = 5.7, P < 0.0001).
  
  
  CONCLUSIONS
  Acupuncture and exposure to dirty needles are independent risk factors of HCV infection. Asians coming from endemic areas should be screened for HCV even when commonly-known risk factors for Western patients are not present.
authors.affiliation: Pacific Health Foundation, San Jose, CA, USA, kevin.kin@gmail.com.
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Kin
authors.forename: Brian
authors.initials: B
authors.lastname: Lin
authors.forename: Kevin T
authors.initials: KT
authors.lastname: Chaung
authors.forename: Nghiem B
authors.initials: NB
authors.lastname: Ha
authors.forename: Huy N
authors.initials: HN
authors.lastname: Trinh
authors.forename: Ruel T
authors.initials: RT
authors.lastname: Garcia
authors.forename: Huy A
authors.initials: HA
authors.lastname: Nguyen
authors.forename: Khanh K
authors.initials: KK
authors.lastname: Nguyen
authors.forename: Brian S
authors.initials: BS
authors.lastname: Levitt
authors.forename: Eduardo B
authors.initials: EB
authors.lastname: da Silveira
authors.forename: Mindie H
authors.initials: MH
authors.lastname: Nguyen
mesh_terms: D015670:Acupuncture Therapy / Q000009:adverse effects; D000328:Adult; D000368:Aged; D000914:Antibodies, Viral; D001213:Asian; D016022:Case-Control Studies; D005260:Female; D016174:Hepacivirus / Q000302:isolation & purification*; D006526:Hepatitis C / Q000453:epidemiology* / Q000208:ethnology / Q000209:etiology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors; D013653:Tattooing / Q000009:adverse effects; D065227:Transfusion Reaction; D014481:United States / Q000453:epidemiology
chemical_list: D000914:Antibodies, Viral